The elderly: Health status benefits and recovery of function one year after coronary artery bypass surgery

被引:39
作者
Conaway, DG [1 ]
House, J [1 ]
Bandt, K [1 ]
Hayden, L [1 ]
Borkon, AM [1 ]
Spertus, JA [1 ]
机构
[1] Univ Missouri, Kansas City, MO 64110 USA
关键词
D O I
10.1016/S0735-1097(03)01052-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES The purpose of this study was to describe the health status (symptoms, function, and quality of fife) changes of elderly patients undergoing coronary artery bypass grafting (CABG) and compare these to younger patients. BACKGROUND Despite increasing use of CABG in the elderly, few data exist about elderly patients' health status benefits from CABG. METHODS A total of 690 consecutive patients (n = 156, >75 years of age; n = 534, less than or equal to75 years of age) from a single center were administered the Seattle Angina Questionnaire (SAQ) at baseline and at one year. The first 224 patients were also given monthly questionnaires for six months after CABG. RESULTS Although peri-operative mortality was similar (2.6% vs. 2.2%, p = NS), one-year mortality was greater in older patients (11.5% vs. 5.4%, p = 0.008). Among survivors, similar health status benefits were observed one year after surgery (SAQ change scores for Physical Function 21.5 +/- 27.0 vs. 19.7 +/- 27.0, p = 0.67; Angina Frequency 30.1 +/- 25.7 vs. 24.6 +/- 25.6, p = 0.07; and Quality of Life 37.7 +/- 21.8 vs. 33.6 +/- 25.2, p = 0.16). In 224 patients assessed monthly, elderly patients' physical function scores were significantly lower than the younger group until one year. The age-time interaction term was significant (p = 0.003), confirming a slower recovery of physical function. In contrast, angina relief and quality of life improvement did not differ by age. CONCLUSIONS Despite a slower rate of physical recovery, older patients derived similar health status benefits from CABG compared with younger patients. These data should assist physicians in counseling elderly patients and suggest that age alone should not be a deterrent for recommending bypass surgery. (C) 2003 by the American College of Cardiology Foundation.
引用
收藏
页码:1421 / 1426
页数:6
相关论文
共 23 条
[1]   A comparison of observational studies and randomized, controlled trials. [J].
Benson, K ;
Hartz, AJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (25) :1878-1886
[2]   Identification of variables needed to risk adjust outcomes of coronary interventions: Evidence-based guidelines for efficient data collection [J].
Block, PC ;
Peterson, EC ;
Krone, R ;
Kesler, K ;
Hannan, E ;
O'Connor, GT ;
Detre, K .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 32 (01) :275-282
[3]  
CONCATO J, 2000, NEW ENGL J MED, V342, P1907
[4]   Cardiac surgery in the elderly [J].
Dalrymple-Hay, MJR ;
Alzetani, A ;
Aboel-Nazar, S ;
Haw, M ;
Livesey, S ;
Monro, J .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1999, 15 (01) :61-66
[5]   Transforming self-rated health and the SF-36 scales to include death and improve interpretability [J].
Diehr, P ;
Patrick, DL ;
Spertus, J ;
Kiefe, CI ;
McDonell, M ;
Fihn, SD .
MEDICAL CARE, 2001, 39 (07) :670-680
[6]  
FAIRCLOUGH DL, 1996, QUALITY LIFE PHARMAC, P427
[7]   Cardiac surgery in octogenarians: Can elderly patients benefit? Quality of life after cardiac surgery [J].
Fruitman, DS ;
MacDougall, CE ;
Ross, DB .
ANNALS OF THORACIC SURGERY, 1999, 68 (06) :2129-2135
[8]   CORONARY ARTERIOGRAPHY AND CORONARY-ARTERY BYPASS-SURGERY - MORBIDITY AND MORTALITY IN PATIENTS AGES 65 YEARS OR OLDER - A REPORT FROM THE CORONARY-ARTERY SURGERY STUDY [J].
GERSH, BJ ;
KRONMAL, RA ;
FRYE, RL ;
SCHAFF, HV ;
RYAN, TJ ;
GOSSELIN, AJ ;
KAISER, GC ;
KILLIP, T .
CIRCULATION, 1983, 67 (03) :483-491
[9]  
HEGYELI RJ, 1999, AM J GERIATR CARDIOL, V8, P155
[10]   Coronary artery bypass grafting in the elderly [J].
Hirose, H ;
Amano, A ;
Yoshida, S ;
Takahashi, A ;
Nagano, N ;
Kohmoto, T .
CHEST, 2000, 117 (05) :1262-1270